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J Pediatr. 2017 Mar;182:28-33.e1. doi: 10.1016/j.jpeds.2016.10.034. Epub 2016 Nov 11.

Cerebellar Microstructural Organization is Altered by Complications of Premature Birth: A Case-Control Study.

Author information

1
Montreal Children's Hospital, Division of Pediatric Neurology, McGill University Health Centre, Montreal, Quebec, Canada; School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.
2
Section of Pediatric Neuroradiology, Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD.
3
Division of Diagnostic Imaging and Radiology, Children's National Health System, Washington, DC.
4
Division of Diagnostic Imaging and Radiology, Children's National Health System, Washington, DC; Developing Brain Research Laboratory, Children's National Health System, Washington, DC.
5
Center for Translational Science, Children's National Health System, Washington, DC.
6
Fetal and Transitional Medicine, Children's National Health System, Washington, DC.
7
Division of Diagnostic Imaging and Radiology, Children's National Health System, Washington, DC; Developing Brain Research Laboratory, Children's National Health System, Washington, DC. Electronic address: climpero@childrensnational.org.

Abstract

OBJECTIVES:

To compare regional cerebellar microstructure, as measured by diffusion tensor imaging (DTI), between preterm infants at term-equivalent age and healthy term-born control neonates, and to explore associations between DTI findings and clinical risk factors.

STUDY DESIGN:

In this case-control study, DTI studies were performed in 73 premature infants born ≤32 weeks and ≤1500 g birth weight and 73 full-term-born controls from healthy pregnancies. Using a region of interest approach, fractional anisotropy (FA) and mean diffusivity (MD) were extracted in 7 cerebellar regions including the anterior vermis, the right/left superior cerebellar peduncles, the middle cerebellar peduncle, and the dentate nuclei. To validate further our DTI measurements, we measured FA and MD in the genu of the corpus callosum and splenium. FA and MD were compared between groups using analyses of multiple linear regression models.

RESULTS:

Preterm infants at term-equivalent age presented with higher FA in the dentate nuclei (<.001) and middle cerebellar peduncle (.028), and lower MD in the vermis (.023) compared with controls. Conversely, preterm infants showed reduced FA and increased MD in both the genu of the corpus callosum and splenium (P < .001). Independent risk factors associated with altered FA and MD in the cerebellum included low Apgar score, supratentorial injury, compromised cardiorespiratory function, and surgery for necrotizing enterocolitis and patent ductus arteriosus.

CONCLUSIONS:

This DTI study provides evidence that complications of premature birth are associated with altered cerebellar microstructural organization when compared with term-born control infants.

KEYWORDS:

cerebellar injury; cerebellum; microstructure; prematurity

PMID:
27843009
DOI:
10.1016/j.jpeds.2016.10.034
[Indexed for MEDLINE]

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